Individual
KAITLIN ELESE NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1337 FARMSTEAD LN, BOLINGBROOK, IL 60490-5479
(630) 901-0629
Mailing address
347 S GLADSTONE AVE, AURORA, IL 60506-4877
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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